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Online Membership Application

Company Information

Company:

*

Address Line 1:

*

Address Line 2:

City:

*

State:

*

Zip:

*

Phone 1:

*

Phone 2:

Fax:

E-mail:

*

Website:

Bus. Category 1:

Bus. Category 2:

Established Date:

Full-time Employees:

*

Part-time Employees:

*

Business Description:

Character Limit: 0/500

Logo:

Images must be less than 1MB in file size.

Image size may not exceed 1MB.

Tell us more about your business.

My business would like to accept Chamber Gift Certificates:

Create Member Account Login

Your member account allows you to update your information online via a secure login.

Admin E-mail:

*

Password:

*

Verify Password:

*

Contacts

Primary Contact

Prefix:

First Name:

*

Last Name:

*

Suffix:

Familiar Name:

Title:

Create Login

Your member login allows you to update your information online and register for events.

Username:

*

Password:

*

Verfiy Password:

*

Use Company contact information

Billing Contact

Send invoices to Primary Contact

Annual Parnership Investment

Business Membership

# Employees

Annual Dues

1-4

$220.00

5-9

$270.00

10-19

$320.00

20-29

$370.00

30-39

$430.00

40-49

$480.00

50-74

$600.00

75-99

$700.00

100-149

$800.00

150-199

$900.00

200-299

$1,000.00

300-499

$2,000.00

500+

$3,000.00

$220.00

Home Based

$150.00

Non-Profits & Churches*

*Non-governmental entities; less than 30 employees

$160.00

School Corporation

$350.00

Banks

$16 per million in assests

$16.00

Seasonal/Part Time

Contact the chamber for pricing.

Booth Space

Main business must be a Chamber Member.

$100.00

Total Annual Rate:

$0.00

Prorated Rate: Due Now:

Security Code:

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